MRSA...Please Help

  1. I need everything you know about MRSA.
    I was called this week by a coworker and friend who has been sick lately and just learned she is MRSA positive ( a carrier).
    She and I worked together on a case that I was on for over a year.
    She called as a friend thinking that I might want to know that she tested positive (I did).
    She called as a nurse who had lost the rest of her team to ask if I remembered when the diagnosis was made because she heard it from the mom but it was nowhere on the home chart or POC.
    She is still on the case and I am with a new baby.
    I replied that MRSA was never diagnosed in the time I worked there and it was never on a POC prior to her starting the case. We would certainly have told her.

    I called the agency DON and asked why we did not have Lab work included in our home charts and what we were supposed to do to protect ourselves without correct information or protective gear.
    I have heard from up my chain of command so far that
    "90% of all nurses have colonized MRSA in their noses".
    "40 percent of the population are carriers of MRSA, no big deal"
    "We are in HIPPA violation for discussing this and should have let the agency handle it by calling us". The original nurse did report to her case manager (whose job it is to keep POC updated).
    The DON of agency is saying that just gloves and handwashing are sufficient precaution for trach. colonized MRSA but she has a call in to the CDC to see what is required.

    So, from that one phone call I am hearing that in the days since they have known about the first nurse testing positive the primary concern of the agency is to contact CDC and see what they are liable for.
    ????????
    Thanks for the call to warn me and all the other nurses that we might want to get tested. :angryfire

    I have never NOT felt safe in home health simply because I have always known my babies and their histories and work on average of 1-2 years with each case. This really sux though. I am more angry I think that the agency doesn't care more about us in the field. The DON actually asked me if I could afford the HIPPA fine for talking to my co-worker about this since I was no longer on that particular case.

    My Doctor fit me in at 9 this morning and ordered chest x-ray, CBC, UA with culture and did a throat culture. I just finished all that and now am worried because the other nurse had her nares cultured but he did my throat. I am getting such mixed information and being made to feel like a bad nurse for being worried about my own health.
    The other nurse is on isolation with Hibiclens showers X5days, Doxy, Bactroban swabs to the nares X5 weeks. After the 5 day isolation and Doxy she may return to the outside world and continue meds until reswabbing in 5 weeks or so. Her doctor is certainly not taking it lightly and doesn't think it's ok for her to just be a "carrier".
    What experience does anybody have in Hospital and other settings with dealing with MRSA?

    I think we are getting swept under the rug here because the agency in question is
    a) worried about their own OSHA violations and
    b) getting flack from the mom involved because nurses have refused to go back out on the case without masks, gowns and OSHA compliant protective gear as well as family compliance with isolation techniques when baby has a fever etc..
    Help.......going to take a shower. :
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  2. 5 Comments

  3. by   kids
    I have worked with several MRSA colonized children (trachs) and per our county health department, CDC and an infection control doctor no special precautions other than universal precautions were needed except during an acute illness.

    It is scarey to consider that you could carry something home to your family. The cdc does have a wealth of information on MRSA http://www.cdc.gov/ncidod/hip/ARESIST/mrsa.htm
  4. by   nursex20
    ........no special precautions other than universal precautions were needed except during an acute illness.

    That is what is scaring me after so long out there. I can't count how many fevers I have nursed that baby through over a year and we had no idea that anything but Universal was required.
  5. by   NRSKarenRN
    containing methicillin-resistant s aureus
    http://www.postgradmed.com/issues/2001/10_01/simor.htm


    [color=#3366ff]mrsa. johns hopkins.
    explains infection vs. colonization and discusses implications for hospital care.


    mrsa is a recordable occupational illness
    health and safety | massachusetts nurses association



    [color=#3366ff]mrsa - methicillin resistant staphylococcus aureus. cdc.
    covers transmission, colonization and infection, and standard precautions.
    if additional help is needed by the hospital, a consultation with the local or state health department or cdc may be necessary.

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    [font=verdana, arial, helvetica, sans-serif]http://www.cdc.gov/drugresistance/healthcare/webresources.htm

    [font=verdana, arial, helvetica, sans-serif]cdc's main antimicrobial resistance site

    [font=verdana, arial, helvetica, sans-serif]issues in healthcare settings: antimicrobial resistance
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    ajn:
    emerging infections: mrsa, vre, and vrsa how do we control them in nursing homes?summary: outline identifying multidrug-resistant organisms cdc recommendations for case management standard precautions for all. contact precautions for some. references with the transfer of nursing home residents to and from acute-care settings, it was inevitable that ...

    preventing nosocomial spread of mrsa is in your hands





  6. by   NancyJo
    My facility puts all MRSA's in contact isolation, which is acute care.However when we transfer someone to LTC if they are colonized they are not in isolation, only universal precautions, usually depending on their policies.
  7. by   LPNer
    Quote from NancyJo
    My facility puts all MRSA's in contact isolation, which is acute care.However when we transfer someone to LTC if they are colonized they are not in isolation, only universal precautions, usually depending on their policies.
    Same here at my hospital and I've always wondered about D/C. Why? If we, in the hospital, can pick it up and carry it next door, why can't they in a LTC facility?
    I've read many articles about the patho and still have this same question. Are they or are they not a potential problem? I say yes from what I have read, but it just doesn't make sense that it doesn't follow to the next facility.
    I HAVE to be missing something in there. Of course our facility uses contact for a HX of MRSA, maybe that is the difference, hah! may have answered my own question finally!

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